Join 3,422 readers in helping fund MetaFilter (Hide)


wellbutrin makes me feel worse
September 13, 2012 5:04 PM   Subscribe

My doctor prescribed me buproprion (generic Wellbutrin) for anxiety/depression and I feel like I'm even more anxious. Is this normal?

Hi, this is my last questions:
http://ask.metafilter.com/223205/Anxious-and-depressed
After that question I made an appointment with my doctor and she prescribed buproprion for depression/anxiety.
I've been on it 1.5 weeks. I've been increasingly more anxious since I've been on the medication. I've had an increasing sense of nervous dread, which is a terrible terrible feeling to carry all day. I've had two panic attacks, which was very very scary. And since I the dosage was upped to 300 mg two days ago I feel like I'm on speed. I kind of feel like I'm ready to jump out of my own skin. On the one hand I've accomplished a lot, but I can't stop fidgeting or getting up to walk around. I can't concentrate. I could feel the panic attack building up today and I tried to do things to push it away - run, spent time with friends, read alone, but I couldn't stop thinking about my work and it happened while I was driving.

I really like my job when I am there. I love being with my patients and I like my coworkers. It is the anticipation of making mistakes or getting in trouble that cripple me. It's the anticipation of work the night before, and today the day before.

I called my doctor after a panic attack today. She prescribed me a very low dosage of ativan to take when I felt the attack building up, and said that if I didn't stop feeling anxious in another week we should switch the stop the wellbutrin and try something else.

I am TERRIFIED of taking ativan. I do not want to be a zombie. I do not want to become addicted to it. I want to ride this out because I want this medication to work so I can feel better, and I am definitely willing to give it another week. But it seems like I am taking a medication that makes me feel worse, and taking something else to alleviate the anxiety caused by the first medicine doesn't make sense.

Has anyone heard of wellbutrin causing even more anxiety in someone? The onset is supposedly 1-3 weeks, and if this is how I feel at week one I'm actually frightened for the next week. This is so silly because I work in the health care field and I feel like I should be well-versed in these things.

Also, what is ativan like? Does it make you feel like a zombie? I have taken triazolam for sleep and I can't imagine relying on that to function in day to day life, it makes me a different person.

ALso, I just make an appointment with a therapist.
posted by anonymous to Health & Fitness (38 answers total) 5 users marked this as a favorite
 
I can speak to the Wellbutrin part of your question, as I have been on it in the past. Yes, it definitely can increase anxiety. It did for me, and as that is something I struggle with, it ended up being the wrong prescription for me.
posted by bluespark25 at 5:11 PM on September 13, 2012 [3 favorites]


IANAD, but I have been on buproprion for a couple months, and it was terrible; I was just as anxious as off the medication. My anxiety didn't increase, but it was the same. It also gave me terrible insomnia.

Talk to your doctor, Let them know that the meds aren't working for you. If they're not receptive, get a new doctor.

I'll also say that Ativan is a lifesend. Talk to your doctor about taking a half of a dose if you're feeling nervous about it.
posted by furnace.heart at 5:13 PM on September 13, 2012


Has anyone heard of wellbutrin causing even more anxiety in someone?

Yes. I think it's a pretty common (side)effect. I know several people who have been on Wellbutrin for different reasons--depression, smoking cessation--and anxiety and panic attacks are common complaints. Talk to your doctor before you stop taking them, though; I've seen some harsh withdraws from anti-depressants. (IANAD, so I don't know 1.5 weeks is long enough for withdraw, but better safe than sorry.

ALso, I just make an appointment with a therapist.

Good. I read your last post and it resonated with me, the personality shift after returning to high-stress schooling. Therapy has helped me tremendously. I hope that it helps you as well. The return to my pre-stress self has been hard, and frankly, pretty weird, but therapy can be extremely effective in a situation like yours (and mine).

MeMail me if you want to discuss the therapy aspect further.
posted by peacrow at 5:16 PM on September 13, 2012


Tell your doc. It sounds like this is the wrong med for you. People metabolize medication differently.
posted by Sidhedevil at 5:16 PM on September 13, 2012


Yes, Wellbutrin winds you up. Nthing the suggestions to talk with doc and try a different med.
posted by scratch at 5:19 PM on September 13, 2012


Has anyone heard of wellbutrin causing even more anxiety in someone?

I was on it for smoking cessation, not anxiety, but yeah it made me feel tense, speedy and anxious, and like the top of my head was going to fly off. Hated it. (And it didn't work for the smoking cessation, either.)
posted by trip and a half at 5:19 PM on September 13, 2012


I've taken generic Wellbutrin and it can be speedy; my doctor told me Wellbutrin is the only drug he ever advises his patients not to take generically. My understanding is that while generic drugs are regulated heavily, fillers are not, and the type and amount can alter the absorption speed in your body, and that Wellbutrin is a speedy drug to start with, even when you take the brand name.

I am not a doctor nor in any way an authority on prescription meds or the FDA or drug manufacturing, just repeating what my doctor told me.

I do think 1.5 weeks isn't very long to feel out an anti-depressant and that if your doctor prescribes a short term anti-anxiety drug you can work with them to limit the dosage and manage any fears you have about dependency, and I think it would probably be okay to lean on your doctor for guidance here--they're really there to help manage those concerns and I think it would be a good idea to fully talk to them about this and engage them in your care.
posted by A Terrible Llama at 5:22 PM on September 13, 2012


I take Wellbutrin. When I first started it, I was restless, sleepless, pretty head-spinny, had crazy ass dreams. It took a solid month for those things to subside. But I'm glad I waited because it has been well worth it. Pretty much a life-changer for me honestly.
And ativan is also the shit. It really just kind of takes the edge off when you need it. Take a half-pill if you're nervous about it.
posted by greta simone at 5:25 PM on September 13, 2012 [3 favorites]


it absolutely increased my anxiety in the first couple weeks, but that feeling did go away. overall the drug helped me get over a really rough patch, and I'm so glad I stuck it out. I second asking about an anti-anxiety drug for a limited time.
posted by changeling at 5:27 PM on September 13, 2012


Has anyone heard of wellbutrin causing even more anxiety in someone? The onset is supposedly 1-3 weeks, and if this is how I feel at week one I'm actually frightened for the next week. This is so silly because I work in the health care field and I feel like I should be well-versed in these things.

Trust your experience, dude. Even if you were the only person in the world who was experiencing this side effect, it would still be (a) real and (b) important.

And experiencing side effects doesn't mean there's something wrong with you. It's not like "Oh, well, you're in a medical field, so You Oughta Know Better, if you really were on top of your shit you'd never experience any side effects from anything." When the fanciest doctor in the world takes a drug that causes vomiting, he pukes, you know?

Talk to your doctor. Tell him how you feel. TELL HIM THAT YOU'RE SCARED TO CONTINUE, because that's a relevant bit of data -- his conclusion won't be "Oh god my patient is a crazy wussy-ass irrational wimp," it'll be "Huh, this helps me understand how anxious this drug is making him, that's good to know." And then see what he says.
posted by nebulawindphone at 5:28 PM on September 13, 2012 [2 favorites]


I've taken the generic and the non-generic and can say that the generic made me feel way more speedy and anxious than the non-generic, but that it also subsided after about three or four weeks. My experience with non-generic Wellbutrin has been better -- the speedy feeling was never as strong and what side-effects there were went away quickly.

Nthing Ativan is the shit. Half-pill should be fine, it takes the edge off nicely.
posted by Felicity Rilke at 5:28 PM on September 13, 2012


I took Wellbutrin for a couple of years, some years back. It was pretty speedy and I felt pretty whacky for the first few weeks. It subsided, though, and I was fine after that. Ativan is lovely, though, I don't think you will be a zombie, or stoned or anything like that. If you're worried about it, take half to try it out, but I really think you'll be fine. Good luck.
posted by upatree at 5:30 PM on September 13, 2012


Wellbutrin is a stimulant, that is prob what's setting you off. If you're getting worse get off it. I think you can just go cold turkey.
posted by schroedinger at 5:34 PM on September 13, 2012


Ativan is nothing. It just makes you feel a bit more calm. It really works (in my opinion). I've taken pretty low doses of it & felt fine, so I wouldn't be too afraid. Just got with the lowest dose possible if you need it, you'll be fine. I don't feel there's anything to be terrified of.
posted by readygo at 5:37 PM on September 13, 2012


This was my experience as well. It turned me into a caffeinated squirrel.
posted by 4ster at 5:41 PM on September 13, 2012


I agree with A Terrible Llama in that "my doctor told me Wellbutrin is the only drug he ever advises his patients not to take generically."

Generic Wellbutrin made me feel speedy and slightly anxious. However, the brand-name Wellbutrin XL (extended release) formulation, at only 150mg, did not have those effects. It raised my mood immensely, enough to help me to function better regularly. Ultimately it was the boost I needed to get on a better productive track, and start managing and treating my depression without drugs through exercise, diet, and nutritional supplements.
posted by Ardea alba at 5:43 PM on September 13, 2012


Wellbutrin winds you up especially at first. It is perfectly fine to take something to take the edge off.
posted by St. Alia of the Bunnies at 6:05 PM on September 13, 2012 [1 favorite]


Wellbutrin was terrible for me as well. I couldn't tolerate the anxiety after being on it for 2 weeks. Ativan will not make you a zombie. It will make you less anxious and it's often prescribed to people while they wait for the antidepressant to take effect. If you take it for a few weeks at the dose suggested you are not going to get addicted to it. Take it - there's no need to deal with this level of anxiety when you have education to treat it.
posted by Sal and Richard at 6:05 PM on September 13, 2012 [1 favorite]


I've taken Wellbutrin/bupropion. A couple of things I remember about it:

Wellbutrin really needs to be titrated carefully. Increasing the dosage too quickly can be extremely jarring--I experienced racing thoughts and trouble sleeping/vivid dreams. At my doctor's suggestion, I lowered my dosage and slowly increased it over (I think) three weeks. After I was back at the maximum, I was fine.

The bad generic formulation was produced by Teva Pharmaceuticals, and the problem had something to do with their extended release mechanism--it didn't release the drug in quite the same way and led to different serum concentrations than original recipe Wellbutrin. The FDA calls it bioequivalent ("good enough") but I certainly believe that this could be the basis for a different subjective experience of the drug's effectiveness, and, when you're taking a drug for anxiety or depression, it's all about subjective experience.
posted by pullayup at 6:10 PM on September 13, 2012


I became very aggressive on generic Wellbutrin and ended up going off it (tapering down with the reverse of the dosage the doctor had me take to taper up, if that makes sense).
posted by Sweetie Darling at 6:13 PM on September 13, 2012


A close friend takes Ativan, and likes it; it seems calming, but doesn't make you feel loopy. That said, his doctor prescribed it specifically because anxiety was interfering with his sleep - he thought Ativan was good to take at night, because it would make him sleepy. It does, in fact, make him sleepy. You also can't drink while taking it.

I am on Buspar, which most people don't seem to like. I think it is The Awesome - it just cuts out the background noise of anxiety. That's it. No side effects, no weirdness, but my stress level is suddenly turned down from 10 to 2. I don't think it does anything for depression, but there is literature out now that seems to suggest positive benefits of combining buspar with an antidepressant.

I am not a doctor, and not qualified to prescribe anything at all.
posted by vivid postcard at 6:35 PM on September 13, 2012


I was on wellbutrin for a little while and your description is pretty similar to my experience. I was prescribed and antipsychotic along with the wellbutrin to handle the anxiety and help me sleep, but like you, I was terrified to take something that might make me feel like a zombie. I ended up riding the anxiety out for a few weeks, but I think it's important to note that I was also getting some talk therapy for my anxiety for the first two months of te prescription- the skills I learned in my few appointments have helped me immensely. That said, I was only one or two sessions in before the wellbutrin speediness leveled out, so it wasn't just those keeping my anxiety in check. Like greta simone, I'm glad I stuck it out because wellbutrin was definitely a life changer for me. I only took it for 6 months after years and tears of depression and anxiety, and felt brand new.

I would talk to your doctor about your anxiety about taking the ativan, and maybe look for some alternatives that you're more comfortable with. Consider seeking out some kind of Cognitive Behavioural Therapy, if you're not already. I hope you're feeling well soon.
posted by sunshinesky at 7:32 PM on September 13, 2012


I take Wellbutrin. I found it incredibly speedy at first, and had anxiety attacks, shortness of breath and palpitations, crazy dreams and little sleep. That lasted about six to eight weeks. However, after that, it was fantastic. Like greta_simone, I have found it life-changing.

In my experience dosing is finicky. I was on 150 mg when I experienced the agitation, then got better. About six months later, I found depression returning, and upped the dosage to 300 mg. That gave me full blown panic attacks and vertigo, so I went back down to 150 mg. About six months after that, my mood was so depressed I stopped taking it altogether, convinced it was doing nothing at all. DON'T DO THIS. What followed is the most profound depression I have ever experienced, with serious threat of suicide. After a lot of dicking around with other drugs, I eventually got back on the Wellbutrin and have now been on 150 mg when I wake up and 150 mg at bed time and it's been perfect.

I also have generalized anxiety disorder and the Wellbutrin has helped with it quite a bit. However, I really do have to stress that, for me at least, it's a very delicate balance: if I miss a dose or two, I feel it in my mood very quickly; similarly, if I take two doses too close together, there's a spike in anxiety. My therapist would like to see me on Ativan for breakthrough anxiety as your doctor has suggested, buy my doctor doesn't prescribe benzodiazapines so I just tough it out. If I could easily get Ativan for occasional use I would be all over it, though.

tl;dr I think it's worth it to give the Wellbutrin a good 6-8 weeks if you can manage the side effects with Ativan. If you decide the side effects are too awful for an 8 week trial, DO NOT QUIT IT COLD TURKEY as that can be VERY VERY BAD.
posted by looli at 7:39 PM on September 13, 2012


(Oh, I am taking the XL, found, as others have mentioned, that the generic was noticeably different, and went back to Wellbutrin proper.)
posted by looli at 7:44 PM on September 13, 2012


Bupropion works as a kind of stimulant to the frontal lobe of your brain. For this reason it is also prescribed for ADHD (creating a paradoxical stimulant/calming effect, like Ritalin).

So, yeah, it could definitely make you anxious and jittery while you're getting used to it. A fair amount of people when they start to take it get very wound up and have huge insomnia problems early on until dosage is regulated and their bodies adjust.

That said, it is an extremely helpful neuro-pharmaceutical for the right patients -- helping a lot of people immeasurably who suffer with depression and ADHD, in particular, with very few side effects in general (especially important to people is the lack of sexual side effects; studies show it may even improve your sex life, as a fringe benefit).

It's up to you and your doctor. Waiting it out could really be worth it, but people bail out early with a lot of these drugs. You wouldn't be the first. And, certainly, it could be the wrong drug for you. Everyone's body chemistry is different to some degree.
posted by diabolik at 8:46 PM on September 13, 2012


diabolik says, above:

"Bupropion works as a kind of stimulant to the frontal lobe of your brain. For this reason it is also prescribed for ADHD (creating a paradoxical stimulant/calming effect, like Ritalin)."

I'm not sure what "paradoxical stimulant/calming effect means." The idea that stimulants actually calm people with ADHD has, to my knowledge, been debunked. A person close to me who took Wellbutrin for ADHD had the same effect as the original poster: intolerable anxiety (which he does not experience with e.g. Adderall).

I took Wellbutrin for a short time for depression with a secret hope for simultaneous weight loss (like all stimulants, it can have an appetite-suppression effect). I was started on 150mg. It was a nightmare, as per many other posts above.

The solution was to cut back to a shocking *35 mg.* twice a day. Then I built up. I was still too anxious in general to stay on it long-term, but I'm just saying that people can have *very* different reactions to different doses of these medications and you may need to build up much more slowly than is usual.

I'm not a medical doctor.
posted by DMelanogaster at 5:18 AM on September 14, 2012


Yup, lots of good advice here.

* Extended Release. Believe it. Do it.

* DO NOT DRINK COFFEE on Wellbutrin, at least in the first month. No one ever says this, but they really should. Coffee and starting Wellbutrin is a disaster.

* Most people I know find that the early hideousness subsides. And then there are a lot of upsides in the end.
posted by RJ Reynolds at 5:57 AM on September 14, 2012


Hi there. Wellbutrin at 300 mg gives me such bad general anxiety I cannot leave my house and am regulated to the touch crying thinking about all the things that could be going wrong. 200 helps my depression without increased anxiety.

Ativan has been a god send. I only take it once or twice a week, tops(sometimes none). It doesn't make me groggy, although it will help me sleep at night if I need it to. It just takes away the anxiety, literally that simple. YMMV.

I am also on Abilify, an atypical anti-psychotic.
posted by lettuchi at 6:04 AM on September 14, 2012


Oh, and I am also on the generic wellbutrin and lorazepam.
posted by lettuchi at 6:05 AM on September 14, 2012


I've had long-term experience with both brand-name Wellbutrin and various generics.

My experience has been that brand Wellbutrin works amazingly well. The generics, on the other hand, are a horrible crap-shoot, ranging from "almost as good as the brand" all the way to "makes me suicidal". It all seems to depend on the manufacturer, with the TEVA generics being the absolute worst in terms of emotional rollercoasters and actually increasing the depression and anxiety.

From what I can determine, it all comes down to the release mechanisms in the pills themselves. The brand Wellbutrin was engineered to release the main ingredient in a very controlled, long-term release.The worse generics don't mimic that mechanism and seem to dump a large dose into your system all at once, causing a spike and then a sudden crash. Craziness ensues.
posted by Thorzdad at 6:31 AM on September 14, 2012


I've taken generic Wellbutrin and it can be speedy; my doctor told me Wellbutrin is the only drug he ever advises his patients not to take generically. My understanding is that while generic drugs are regulated heavily, fillers are not, and the type and amount can alter the absorption speed in your body, and that Wellbutrin is a speedy drug to start with, even when you take the brand name.

There is truth to this. Wellbutrin XR is extended release because of a fancy coating on the pill. There are tiny pores in it that let water in, dissolve some of the drug, and then seep out like a soaker hose.

The generics have different mechanisms.

And I did have increased anxiety on the drug too, but (for me) it was the activating kind of anxiety. The "oh shit, I've got to do my bills this month" and then when I did them, I felt good about it. I had crazy dreams, but they were the good kind of crazy that is cathartic and I woke up feeling rested. I think that's the intended effect. If you aren't feeling that, then you should tell your doctor that you want to stop taking it. But be aware that one of the effects of depression is a sort of anxiety about being cured: the feeling that if we don't have depression/anxiety to blame for our shortcomings, that we will find out what our "real" shortcomings are.

My own experience is that depression is very much like addiction as a disease. It tricks us into thinking things that seem perfectly logical at the time. "$10 a pack for cigarettes? Man, that sucks, but it's not like I can do anything about it." Which is objectively silly. Anyway, consider whether your change in anxiety is more along these lines, the depression fighting against you for daring to try to cure it.
posted by gjc at 7:07 AM on September 14, 2012 [1 favorite]


* DO NOT DRINK COFFEE on Wellbutrin, at least in the first month. No one ever says this, but they really should. Coffee and starting Wellbutrin is a disaster.

Oh, definitely. I'm a coffee lover, so this was hard for me, but I found my sensitivity to caffeine was through the roof while I was on wellbutrin. Alcohol as well, but that's expected with a lot of antidepressants. I couldn't drink more than half a bottle of beer before feeling the alcohol in my system.
posted by sunshinesky at 7:18 AM on September 14, 2012


I didn't read all of the above responses, so I apologize if this is repetitive.

I started out on Wellbutrin and did well except for the anxiety spike. My doctor switched me to Effexor XR and I really liked it. The doc told me that Effexor is very similar to Wellbutrin except that it also covers the anxiety problems.
posted by TooFewShoes at 8:07 AM on September 14, 2012


Yep. Wellbutrin is an activating anti-depressant, and definitely not for everybody.
posted by xyzzy at 8:47 AM on September 14, 2012


Wellbutrin caused me psychosis. It is now listed in my medical record as DO NOT EVER, EVER GIVE THIS MED TO THIS PERSON, EVER. written in professional medico-speak.
posted by mcbeth at 10:47 PM on September 14, 2012


It's possible to buy brand Wellbutrin for a relatively reasonable price from a Canada-based Internet pharmacy, with your MD's rx.

Wellbutrin can also be paired with buspirone for anti anxiety. I found that the right balance of the two worked very well for me.

Ativan shouldn't cause anything zombie like but if it did you could just not take it again.

I'd be much more worried about te side effects of SSRIs than of Ativan. But again, each person is different and it may well be necessary to 'take risks' with side effects in order to find the medication that works best in your life.
posted by Salamandrous at 6:25 AM on September 15, 2012


Wow, this is making me want to try brand Wellbutrin. I've always used the generic (first short release, then XL) because I have to pay out-of-pocket and it is impossible to understate the difference it's made in my life.

Like I said, it's a stimulant. When I first started taking it I was a little jittery but didn't have anxiety issues (I was also extremely sleep-deprived so that might've helped stave off the side-effects). I now drink coffee and take it and it's not an issue. So it may also be something that you get used to, but if you're having such a bad time of it then probably best to not push it.
posted by schroedinger at 7:49 AM on September 15, 2012


I'm not sure what "paradoxical stimulant/calming effect means." The idea that stimulants actually calm people with ADHD has, to my knowledge, been debunked.

Can you link to some of the studies that have debunked it? All you mention after saying that is three anecdotal cases.

If your point is that not everyone reacts to stimulants in the same way, I don't think anyone's ever argued against that. People with ADHD, for instance, usually have to try a number of different neuro-pharmaceuticals, in a number of different doses, before finding the formula that works best for them.
posted by diabolik at 2:03 PM on September 23, 2012


« Older El Sabor just posted an iPhone...   |  I'm a freelance web designer i... Newer »
This thread is closed to new comments.